Prenatal diagnosis and perinatal management of fetal sacrococcygeal teratoma

Sacrococcygeal teratoma is the most common fetal neoplasm, with an incidenc e of 1 in 40,000 births. Fetuses with this malformation are at risk for sig nificant perinatal morbidity and mortality. We identified nine fetuses with sacrococcygeal teratomas that were diagnosed antenatally and managed at th e University of North Carolina Hospitals over a 7-year period. We retrospec tively reviewed the charts of mothers and infants and recorded data concern ing perinatal and surgical management. Six infants survived the neonatal pe riod. AII infants diagnosed after 20 weeks' gestation survived. Fetal hydro ps developed in three fetuses, all of whom died. Inadequate ventilation sec ondary to prematurity was a contributing factor in each lethal case. Diagno sis at an early gestational age, development of fetal hydrops, and prematur e delivery predicted a poor prognosis. When possible, we recommend that del ivery be delayed to allow for fetal development. Stabilization of the infan t should be attempted before resection of the teratoma.